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Environmental Information Form <br /> Part B <br /> DATE : April 1987 <br /> (To be Completed By Applicant ) <br /> NOTE : In completing this form, use additional sheets if necessary. <br /> Answer all questions to the best of your ability . If a question <br /> is not applicable to your project, write NA (not applicable ) . <br /> Please do not leave blanks . Incomplete forms cannot be accepted. <br /> PERSON COMPLETING FORM PROPERTY OWNER X AGENT OF OWNER <br /> Name Sr hark & Chiartarnl i Tnr _ <br /> Address 628 Central Ave. <br /> City Tracy <br /> State/Zip CA 95376 <br /> Phone (209)835-2178 <br /> A. PROJECT DESCRIPTION <br /> 1 . Type of application: Q Use Permit, El Major Subdivision, <br /> Zone Reclassification, X1 Minor Subdivision, Q Site Approval, <br /> Zone Variance, Q Other : <br /> 2 . Project location: 20711 So. Reeve Road <br /> Describe the project; i .e . , request being made and nature of use . <br /> Identify specific project components : Division of land request to <br /> create a 1.5 acre homesite for the son of an owner - operator of a <br /> farming enterprise. <br /> 3 . Total acreage of project: 64.3 ± # of existing parcels : one <br /> Assessor Parcel # (s ) : 209-310-20 <br /> 4 . If there is an existing EIR assessing any aspect of your project <br /> site , provide title and date : N/A <br /> 5 . Other permits and approvals (County, Regional , State and Federal ) <br /> required for this project : <br /> PERMIT AGENCY <br /> Percolation Test Co Cal Health <br /> Well ' <br /> Septic Tank <br /> Building Building dept . <br /> Minor Subdivision - 7 - ( 6/86 ) <br />